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接受强化康复治疗的意识障碍患者预后的脑电图预测指标

EEG predictors of outcome in patients with disorders of consciousness admitted for intensive rehabilitation.

作者信息

Bagnato Sergio, Boccagni Cristina, Sant'Angelo Antonino, Prestandrea Caterina, Mazzilli Roberta, Galardi Giuseppe

机构信息

Unit of Neurophysiology and Unit for Severe Acquired Brain Injury, Rehabilitation Department, Fondazione Istituto San Raffaele G. Giglio, Cefalù (PA), Italy.

Unit of Neurophysiology and Unit for Severe Acquired Brain Injury, Rehabilitation Department, Fondazione Istituto San Raffaele G. Giglio, Cefalù (PA), Italy.

出版信息

Clin Neurophysiol. 2015 May;126(5):959-66. doi: 10.1016/j.clinph.2014.08.005. Epub 2014 Sep 1.

Abstract

OBJECTIVE

This study examined the prognostic value of standard EEG in patients with unresponsive wakefulness syndrome (UWS) or in a minimally conscious state (MCS).

METHODS

EEGs recorded at admission in 106 patients with UWS or in a MCS were analyzed retrospectively. EEG amplitude, dominant frequency, and reactivity to stimuli were correlated to patient outcomes according to the Coma Recovery Scale Revised (CRS-R). In 101 patients, data were integrated to generate a novel Amplitude-Frequency-Reactivity (AFR) scale, with scores ranging from 3 to 7.

RESULTS

Patients with reduced amplitudes showed less improvement in CRS-R scores at 3 months compared to patients with normal amplitudes. Delta, theta, and alpha frequencies were associated with the least, intermediate, and the greatest improvement in CRS-R scores, respectively. Patients with EEG reactivity showed greater improvements in CRS-R scores than patients without reactivity. The AFR scores for these patients were correlated with outcomes.

CONCLUSIONS

Reduced EEG amplitudes and delta frequencies correlated with worse clinical outcomes, while alpha frequencies and reactivity correlated with better outcomes. AFR scores allowed more delineated descriptions of outcomes in patients with normal amplitude, theta frequency, and no reactivity.

SIGNIFICANCE

Standard EEG descriptors are related to the 3-month outcomes in patients with disorders of consciousness.

摘要

目的

本研究探讨标准脑电图对无反应觉醒综合征(UWS)或微意识状态(MCS)患者的预后价值。

方法

回顾性分析106例UWS或MCS患者入院时记录的脑电图。根据修订的昏迷恢复量表(CRS-R),将脑电图振幅、主导频率和对刺激的反应性与患者预后相关联。在101例患者中,整合数据以生成一种新的振幅-频率-反应性(AFR)量表,分数范围为3至7。

结果

与振幅正常的患者相比,振幅降低的患者在3个月时CRS-R评分改善较少。δ、θ和α频率分别与CRS-R评分改善最少、中等和最大相关。脑电图有反应性的患者比无反应性的患者CRS-R评分改善更大。这些患者的AFR评分与预后相关。

结论

脑电图振幅降低和δ频率与较差的临床预后相关,而α频率和反应性与较好的预后相关。AFR评分能够更清晰地描述振幅正常、θ频率且无反应性患者的预后。

意义

标准脑电图指标与意识障碍患者的3个月预后相关。

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